Teenage Sports Injuries

Support for recovery, strength and a safe return to sport

Teenagers who take part in sport place significant physical demands on a body that is still growing and developing.

Injuries may happen suddenly during training or competition, or develop gradually when repeated activity places more demand on the body than it is currently able to manage.

Teenage sports injury physiotherapy focuses on identifying what is causing the problem, restoring movement and strength, and helping the young athlete return to sport with confidence.

Treatment is adapted to the injury, stage of growth, sport and level of competition rather than simply using an adult rehabilitation programme.

When physiotherapy may help

An assessment may be useful for teenagers experiencing:

• Knee pain
• Ankle sprains
• Repeated ankle injuries
• Hip or groin pain
• Shin pain
• Heel pain
• Shoulder pain
• Back pain
• Muscle strains
• Ligament injuries
• Tendon pain
• Pain during running
• Pain during jumping or landing
• Reduced strength after injury
• Difficulty returning to sport
• Repeated injuries in the same area
• Pain that gradually increases with training

Physiotherapy may also help when an injury has settled but the athlete does not yet feel ready for full training or competition.

What happens during the first appointment?

The first appointment begins with a discussion about the injury and the sport involved.

The physiotherapist may ask about:

• How the injury happened
• When symptoms started
• Training frequency
• Competition schedule
• Recent increases in training
• Previous injuries
• Current pain
• Activities that make symptoms worse
• School PE
• Strength and conditioning
• Other sports or physical activities
• Growth changes
• Recovery and rest
• Goals for returning to sport

The physical assessment may include:

• Joint movement
• Muscle strength
• Balance
• Walking
• Running
• Squatting
• Jumping
• Landing
• Hopping
• Changes of direction
• Sport-specific movements

The assessment helps identify both the injured area and any physical factors that may affect recovery.

What treatment may include

Treatment depends on the injury and the stage of recovery.

Strengthening

Strengthening may focus on the muscles needed to support the injured area.

Exercises may involve:

• Hips and gluteal muscles
• Legs
• Calves
• Hamstrings
• Quadriceps
• Core and trunk muscles
• Shoulders and upper body

The programme can gradually progress from basic movements towards heavier and faster exercises.

Mobility exercises

Some injuries result in stiffness or reduced movement.

Mobility exercises may help restore comfortable movement while respecting the healing stage of the injury.

Balance and control

Balance and coordination are particularly important after injuries such as ankle or knee sprains.

Exercises may include:

• Single-leg standing
• Reaching
• Stepping
• Hopping
• Landing
• Direction changes

The level of difficulty increases as control improves.

Running rehabilitation

If the injury affects running, rehabilitation may gradually progress from walking towards:

• Jogging
• Continuous running
• Faster running
• Sprinting
• Acceleration
• Deceleration

The athlete should be able to tolerate one stage before progressing to the next.

Sport-specific rehabilitation

Later rehabilitation may include movements that reflect the athlete’s sport.

This could involve:

• Kicking
• Throwing
• Jumping
• Landing
• Cutting
• Sprinting
• Changing direction
• Repeated high-speed efforts

The aim is to prepare the athlete for the actual demands of training and competition.

Injuries during growth

Teenagers can experience periods of rapid growth where bones, muscles and tendons are adapting at different rates.

During these periods, movements that were previously easy may temporarily feel less coordinated or more demanding.

Some young athletes may also develop pain around areas where tendons attach to growing bones.

These symptoms should be properly assessed rather than automatically being dismissed as “growing pains”.

Treatment may involve adjusting training temporarily, improving strength and gradually restoring full activity.

Knee pain in teenagers

Knee pain is common in young athletes and can develop during activities such as:

• Running
• Football
• Basketball
• Netball
• Dance
• Gymnastics
• Jumping sports

Symptoms may occur around the front of the knee, below the kneecap or around other parts of the joint.

Assessment may consider:

• Hip strength
• Leg strength
• Knee movement
• Running
• Jumping
• Landing
• Training volume

Treatment is based on the specific cause rather than using one standard programme for all teenage knee pain.

Pain below the kneecap during growth

Some teenagers develop pain around the upper shin just below the kneecap during periods of growth.

It may be aggravated by:

• Running
• Jumping
• Kicking
• Squatting
• Kneeling

Management may include temporary changes to training, strengthening and gradually increasing activity as symptoms allow.

The goal is usually to keep the teenager appropriately active rather than stopping all sport unnecessarily.

Ankle sprains

Ankle sprains are common in sports involving running, jumping and quick direction changes.

After an ankle sprain, the athlete may experience:

• Pain
• Swelling
• Reduced movement
• Weakness
• Poor balance
• Reduced confidence

Rehabilitation may include:

• Ankle movement
• Calf strengthening
• Balance
• Hopping
• Landing
• Running
• Changes of direction

Returning to sport too early without restoring strength and control may increase the likelihood of repeated problems.

Repeated ankle sprains

Some teenagers continue to roll the same ankle repeatedly after the first injury.

This may happen because balance, strength or confidence has not fully recovered.

Rehabilitation may focus on:

• Ankle strength
• Calf strength
• Single-leg balance
• Reaction exercises
• Jumping and landing
• Sport-specific movement

Bracing or taping may sometimes be considered alongside rehabilitation where appropriate.

Heel pain in young athletes

Heel pain can sometimes occur during periods of growth, particularly in teenagers involved in running and jumping sports.

Symptoms may be worse:

• During running
• After sport
• During jumping
• When training volume increases

Management may involve:

• Adjusting activity temporarily
• Calf strengthening
• Improving ankle mobility
• Reviewing footwear
• Gradually rebuilding running tolerance

The approach depends on the athlete’s age, symptoms and sport.

Shin pain

Pain along the shin can develop when running or training volume increases quickly.

Assessment may consider:

• Training changes
• Running
• Calf strength
• Foot and ankle movement
• Recovery
• Playing surface
• Footwear

Not all shin pain has the same cause.

Persistent or localised bone pain should be assessed carefully rather than treated simply as muscle soreness.

Muscle strains

Teenage athletes can experience muscle strains involving areas such as:

• Hamstrings
• Calves
• Quadriceps
• Groin

Early rehabilitation may focus on comfortable movement before gradually rebuilding strength.

Later stages may include:

• Running
• Sprinting
• Stretching under load
• Jumping
• Sport-specific movements

The athlete should be prepared for the speed and intensity required by the sport before returning fully.

Groin and hip pain

Sports involving kicking, sprinting or rapid direction changes can place high demand on the hip and groin.

Treatment may assess:

• Hip strength
• Joint movement
• Running
• Kicking
• Single-leg control
• Training load

Rehabilitation may combine strengthening and gradual return to high-speed movement.

Persistent hip or groin pain should be properly assessed, particularly if it significantly affects walking or normal daily activity.

Shoulder injuries

Teenagers involved in swimming, cricket, tennis, volleyball or throwing sports may experience shoulder pain.

Symptoms can develop gradually when repeated overhead activity exceeds the shoulder’s current capacity.

Treatment may focus on:

• Shoulder strength
• Rotator cuff strength
• Shoulder blade control
• Trunk strength
• Throwing or overhead technique
• Gradual return to training volume

The full movement involved in the sport should be considered rather than focusing only on the shoulder joint.

Back pain in teenage athletes

Back pain can occur in teenagers involved in sports that require repeated bending, rotation, extension or heavy training.

Assessment may consider:

• Movement
• Strength
• Sport
• Training volume
• Recent growth
• Previous injury

Most back pain can be managed conservatively, but persistent or significant pain should be assessed rather than automatically attributed to posture or growth.

Overuse injuries

Not every sports injury happens during one obvious incident.

Some problems develop gradually when training volume or intensity increases faster than the body can adapt.

This may happen after:

• Starting a new sport
• Increasing weekly training
• Adding extra team sessions
• Returning after a break
• Increasing running distance
• Playing several competitions close together

Treatment may include temporarily adjusting training while improving strength and gradually increasing physical capacity.

Training load

Teenagers sometimes participate in several physical activities at the same time.

For example, a young athlete may have:

• Club training
• School PE
• Matches
• Strength training
• Another sport

All of these contribute to overall physical demand.

Rehabilitation may therefore look at the total weekly workload rather than considering only one training session.

Rest and recovery

Recovery is part of training.

Teenagers may need to balance sport with:

• School
• Exams
• Travel
• Sleep
• Social activities
• Other physical activity

A period of reduced recovery can make demanding training harder to tolerate.

This does not mean every injury is caused by lack of rest, but recovery should be considered when planning rehabilitation.

Strength training for teenagers

Appropriately supervised strength training can form part of teenage sports rehabilitation.

Depending on the injury and experience, exercises may include:

• Squats
• Lunges
• Step exercises
• Calf raises
• Deadlift variations
• Pressing
• Pulling
• Resistance machines

The focus should be on controlled technique and gradual progression.

Strength training can eventually become an important part of preparing the athlete for the demands of sport.

Returning to running

Returning to running should usually happen gradually after an injury.

The athlete may progress through:

• Pain-free walking
• Short jogging intervals
• Longer continuous running
• Faster running
• Sprinting
• Sport-specific running

Running volume and intensity can then increase as the athlete demonstrates good tolerance.

Jumping and landing

Sports such as basketball, volleyball, football, gymnastics and athletics require repeated jumping and landing.

Rehabilitation may include:

• Double-leg jumps
• Single-leg hops
• Landing control
• Repeated jumping
• Jumping in different directions
• Jumping under fatigue

The exercises can become progressively closer to the demands of competition.

Changes of direction

An athlete may be able to run in a straight line comfortably but still not be ready for sport.

Many sports require:

• Cutting
• Turning
• Side stepping
• Rapid acceleration
• Sudden stopping

These movements place different demands on the joints and muscles.

They are therefore often included during later-stage rehabilitation.

Returning to team training

Returning to training does not always need to happen in one step.

A gradual return may involve:

• Warm-up only
• Technical drills
• Non-contact practice
• Reduced training duration
• Full training
• Competition

This allows physical response to be assessed before returning to the most demanding stage.

The progression depends on the injury and sport.

Returning to competition

Being pain-free during normal daily life does not necessarily mean an athlete is ready to compete.

Competition may involve:

• Maximum speed
• Repeated sprinting
• Contact
• Jumping
• Fatigue
• Unpredictable movements

Rehabilitation should prepare the athlete for these demands.

Return to competition is therefore based on physical ability and injury recovery rather than time alone.

Returning after a fracture

Fractures may require a period away from sport while the bone heals.

Once medically cleared, rehabilitation may address:

• Joint stiffness
• Muscle weakness
• Balance
• Running
• Jumping
• Sport-specific activity

Although the bone may have healed, surrounding strength and physical confidence can take longer to recover.

Returning after surgery

Some teenage athletes require surgery following significant orthopaedic injuries.

Rehabilitation may progress through stages involving:

• Restoring movement
• Rebuilding strength
• Balance
• Running
• Jumping
• Sport-specific activity

The programme should follow any restrictions provided by the surgeon.

Higher-level return to sport may take considerably longer than returning to normal everyday activity.

Injury and confidence

An injury can affect confidence, particularly when it happened during a specific movement.

A teenager may feel hesitant about:

• Sprinting
• Tackling
• Jumping
• Landing
• Cutting
• Returning to competition

Rehabilitation can gradually reintroduce these movements in a controlled environment.

Confidence often improves as the athlete successfully completes increasingly demanding tasks.

Reducing the risk of another injury

No programme can guarantee that another injury will never happen.

However, rehabilitation can address physical factors that may help the athlete tolerate sport more effectively.

This may include:

• Strength
• Balance
• Landing control
• Running capacity
• Sport-specific conditioning
• Gradual changes in training volume

Continuing some strength and conditioning after returning to sport can also help maintain physical capacity.

Playing through pain

Young athletes may sometimes hide pain because they do not want to miss training, matches or team selection.

Continuing through every symptom is not always the best approach.

Pain that is:

• Increasing
• Affecting normal movement
• Causing a limp
• Reducing performance
• Persisting between sessions

should be assessed.

Early management may allow activity to be modified rather than waiting until the athlete is unable to participate at all.

Does all sport need to stop?

Not necessarily.

Depending on the injury, the teenager may be able to continue some activities while temporarily reducing movements that aggravate symptoms.

For example, rehabilitation may maintain:

• Strength training
• Cycling
• Upper-body exercise
• Technical work
• Other suitable conditioning

The aim is to maintain physical fitness where possible while giving the injured area an appropriate opportunity to recover.

School PE during rehabilitation

School PE can add additional physical demand while an athlete is recovering.

Temporary modification may sometimes be appropriate.

This could involve:

• Participating in lower-impact activities
• Avoiding sprinting temporarily
• Reducing jumping
• Completing rehabilitation exercises instead

The level of participation can gradually increase as recovery progresses.

Teenagers involved in more than one sport

Playing several sports can provide varied physical activity, but it can also increase total weekly training demand.

When an injury develops, it is useful to consider the combined workload from:

• School sport
• Club sport
• Matches
• Additional coaching
• Gym training

Rehabilitation can help establish which activities can continue and which may need temporary adjustment.

When further medical assessment may be needed

Some symptoms require medical assessment rather than continuing to train or relying on exercises alone.

Seek appropriate assessment if there is:

• Severe pain after an injury
• Inability to put weight through a limb
• Significant swelling
• Obvious deformity
• A joint that repeatedly gives way
• Persistent or worsening bone pain
• Pain that regularly wakes the teenager at night
• Unexplained fever or feeling unwell alongside musculoskeletal pain
• Significant numbness or weakness
• A head injury with concerning symptoms
• Loss of consciousness
• Symptoms that are rapidly getting worse

A young athlete whose pain is not improving as expected should also be reassessed.

Treatment based on the athlete’s goals

Rehabilitation should reflect the sport and level the teenager wants to return to.

Goals may include:

• Returning to PE
• Walking or running without pain
• Returning to club training
• Sprinting
• Jumping
• Playing a full match
• Returning to dance or gymnastics
• Returning to competition
• Improving strength
• Reducing repeated injuries
• Feeling confident in the injured area

The rehabilitation programme can become more sport-specific as recovery progresses.

How long does teenage sports injury rehabilitation take?

There is no single recovery timeline.

The length of rehabilitation depends on:

• The injury
• Severity
• Healing requirements
• Stage of growth
• Previous injuries
• Current strength
• Sport
• Training demands
• Whether surgery was required

Minor injuries may require a relatively short period of rehabilitation.

More significant ligament, tendon, fracture or surgical injuries can require a much longer progression before full competition is appropriate.

The goal is to return when the athlete is physically prepared rather than simply when a certain number of weeks have passed.